ATLS Review questions with complete solutions

A 22yo M is hypotensive and tachycardia after a shotgun wound to the L shoulder. His BP is initially 80/40. After 2L of fluids his BP increases to 122/84. HR is 100bpm and his RR is 28. Breath sounds are decreased in the left hemithorax, and a closed tube thoracotomy is performed with a small amount of blood return and no air leak. What is the next step? CORRECT ANSWERS: Reexamine the chest A construction worker falls 2 stories and suffers bilateral calcanea fractures. He now is having back pain. What would confirm diagnosis? CORRECT ANSWERS: Complete spine x-ray series What is the principle of balanced resuscitation? CORRECT ANSWERS: permissive hypotension and early plasma infusion In managing a head-injured patient, what is the most important initial step? CORRECT ANSWERS: Secure the airway A previously healthy 70kg man suffered ~2L of acute blood loss. Which appropriately applies to this patient? CORRECT ANSWERS: His systolic BP will be decreased with a narrowed pulse pressure NOT his pulse pressure will be widened, urinary output at lower level of normal, tachy but no BP change, or maintained systolic BP with elevated diastolic BP The physiologic hypovolemia of pregnancy has clinical significance in the management of severely injured, gravid woman by: CORRECT ANSWERS: increasing the volume of blood to produce maternal hypotension The best assessment of fluid resuscitation of the burn patient is CORRECT ANSWERS: adequate urinary output The diagnosis of shock MUST include: CORRECT ANSWERS: evidence of inadequate organ perfusion A 7yo M is brought to the ED by his parents several minutes after falling through a window. He is bleeding from a 6cm wound on the medial right thigh. Immediate management of the wound should include? CORRECT ANSWERS: Direct pressure on the wound **For the patient with severe traumatic brain injury, around HYPOCARBIA (dec CO2) should be avoided in order to prevent what? CORRECT ANSWERS: cerebral vasoconstriction with diminished perfusion. **A 25yo M is brought in to a facility with a general surgeon after bei